Wherein a surgeon tells some stories, shares some thoughts, and occasionally shoots off his mouth. Like a surgeon.

Thursday, October 25, 2007

The American Dream

[As I did for a past post, I begin with a warning: this is a political rant, so people who come here for surgical stuff should turn away now. But come back: tomorrow it'll be back to usual.]

News item: US Senate rejects measure to provide path to citizenship for children of illegal aliens, if they serve in the military or complete two years of higher education. By "reject," of course, it is meant that it received a majority of votes, but not the super-majority of 60 required to prevent filibuster. (Anyone remember when the Republicans were screaming over Democrats' use of the same ploy -- which is to say both sides are a bunch of shameless hypocrites.)

Personal item: Earlier this week I was a community volunteer, evaluating senior projects at a local high school. The first presentation was by a native-born Caucasian person, who did a lazy and entirely unimpressive job. The next was a young woman who was born in Iraq, sent to a refugee camp in Saudi Arabia, and finally found her way here. Her presentation was dazzling, brilliant. Wearing a hijab and a high-school sweatshirt, she spoke perfect English as she delivered a Powerpoint-backed speech.

One needn't take a stand on the way the US Senate works, or even on the details of immigration -- legal or otherwise -- to recognize this: to the extent that the "American Dream" is still alive, it's becoming apparent that it's more within the bosoms of the non native-born than otherwise. Look at who gets the scholarships, who wins the spelling bees, the science contests. It's not Jones and Jackson. It's Singh and Nguyen, Allawi and Ali, Kim and Yung. (For that matter, since this is a medical blog, look at the doctors being hired everywhere, and those entering med school. In my internship group, in 1970, we were eleven white US-born males, and one white US-born female. In one of the most recent groups, all but one were foreign born, and the one that wasn't was a first-generation immigrant. And I know the standards there haven't changed: it's about who can meet them.) (And if I need to say this to avoid one brand of comment, my point is not about white or male. It's about native vs. foreign born.)

As we are becoming a nation of people who -- for reasons, it seems to me, of resolving conflict in favor of religious belief over scientific fact -- reject evolution, global warming, and the fact that our Earth is older than twelve thousand years; of homeopaths and antivax; of people who would rather turn public schools into churches than training grounds for inquiry; who see open-minded education as a threat and who fail to see that democracy can only survive when the public is broadly educated and encouraged to question political leaders from all parties (and who fail to recognize that the greatest protection of religious freedom and the greatest tribute to its value is to keep it entirely separate from government, and that doing so has led this country to have a higher percentage of believers than any other Western nation) -- as all this is happening at increasing speed and with crescendoing decibels, it's clear to me that the future of America depends on the continuing influx of bright and motivated people from outside her borders. We are ceding greatness -- willfully and aggressively proud-as-hellfully -- to the rest of the world. Of the 70% or so who, in polls, say this country is headed in the wrong direction, I'd bet well over half think it's that we're not insular enough, not religious enough, not creationist-homophobic-unscientific-venomous enough.

There are plenty of great native-born kids. Mine, for one. And his friends. And cousins. And yours. Far be it from me to overstate anything. But as to trends? I'm worried. Really worried. It's not that "our" kids are inferior. It's that we're kissing them off, with a tax-cut and a hallelujah.

Illegal immigration is illegal, and although it appears our economy has depended on it in many ways, it needs to be addressed. But we discourage legal immigration at our peril. Unless the trends among "natives" reverses miraculously, people whose dreams still bring them here are our only hope. And we ought to do what we can to maintain America as (or return it to) a dream-worthy place.

30 comments:

Dr. Schwab,You're right. To be American is about a dream, or even more importantly its about the will to carry that dream out. Who are we if we're not about inner motivation? And what is motivation if its not heart-felt and full of promise?

The US has always had this soft underbelly of religious-nut anti-intellectualism. Each wave of immigrants brought forth the strivers that are pointed to (in time) as proof that the American Dream can be realized. Critical thinking is not only not taught, it's viewed with suspicion and outright hostility. America is rapidly becoming a nation of boobs and the foreign born are the only ones who can counter that trend.Before I left the SF Bay Area afew years back, I remember that the high-achieving Lowell High School was faced with a "crisis." If admission continued to be based on grades, it was going to be almost all Asian! (Nobody got excited when it was all white kids.) But that's where the strivers are coming from -- not from the ranks of the native born. My family came to America early in the 17th century before there even was an America. Four years ago, I moved to Canada to breathe freer air. It was the smartest move I ever made -- what a relief

Even worse - I see it everyday - I'm in college. During my chemistry internship I was one of the only native-born white females. There were others, but they were conducting fluffy research to put on their resumes. It's horribly depressing, but we of small number are still here - we are pressing on. Now if only we would procreate. . . Oy Dr. Schwab, I totally agree with you.

Dr. Sid, it seems as though too many people have forgotten how this country was founded in the first place. Also, based on the article, it sounds like they're already working on another politically irrelevant 'wedge' issue for the upcoming election.

Thomas Friedman floated an excellent idea in a column a few months ago: Anyone who earns a graduate degree in the US automatically qualifies for a green card. It seems to me like those are the sort of people we'd really like to keep around, along with those who put themselves through higher education without access to government financial aid or risk their lives for our country. Apparently though, it's more important to keep Spanish out of Wal-Mart. *sigh*

Sadly, you make the argument, but fail to see it. Our kids, "the native-born caucasian person(s), who did a lazy and entirely unimpressive job" are the product of the "open-minded education" system that you applaud. The foreign born students that are doing well come from cultures with strong family and religious values, and have not been tainted, yet, by your open mindedness.

Local Lynn: not exactly. The kids I saw were born elsewhere, and were in our local school system since primary school. I think they do well because their parents don't listen to Rush. And you're right about differences in schooling abroad vs here. Most people -- even liberals -- agree the US education system is failing in many ways. The difference is that Bush, with No Child Left Behind, chose to deal with it by de-funding the schools that are struggling, as opposed to providing solutions. What we need are good school board members. Oh, wait...

Fortunately, and dispite your best efforts cultures don't loose their family, religious, and morale values in less than one generation. The parents values, from the old country, pervade the young ones until they become parents, and by then, sadly, the liberals have tainted them.

The American dream is for all, not just the newcomers and their children. Why is it that you see only the immigrants as being driven? Let me try to answer that...

The drive to succeed and excel is still alive, but it has moved to other arenas. By your rationale, we should see a similar representation of minorities in financial, legal and business jobs. This has not happened. You are confining your view to a small area with which you are familiar, but in doing so, you blind yourself to the larger shift in society.

Frankly, follow the money, and you'll find the native-born, highly motivated types, alive and doing well in the US. Ease up on the political creed, or save it for a better argument.

anonymous: I was, in particular, addressing kids in our schools, and gave examples. I accept (without knowing) your point that US born may be in other areas. "Follow the money," on the other hand, isn't particularly reassuring: we need good minds in areas of science, of innovation, engineering. Stock brokers aren't going to solve the energy crisis or global warming. It'd be nice for our country if that sort of innovation -- which will make a TON of money -- were developed here. Your argument doesn't reassure, even if it's true.

"Look at who gets the scholarships, who wins the spelling bees, the science contests. It's not Jones and Jackson. It's Singh and Nguyen, Allawi and Ali, Kim and Yung."

People with those sorts of names aren't but a minuscule proportion of our illegal aliens, so they wouldn't have been affected by that bill. I note with interest that you didn't include "Rodriguez" or "Lopez" amongst your examples.

My wife has been trying for years to get a job teaching here in KY, where schools are failing, kids can't read. She taught for many years in Ohio, has a Reading certification, even got a Master's here.

Her problems seem to be that she knows too much, that she might make other teachers look bad, that after years of experience she doesn't want to start out at the lowest rung of the worst school teaching something she isn't qualified to teach, that she isn't just out of college so they can pay her less, that she isn't from here.

There isn't a collective desire to fix the schools when answers stand in front of the decision-makers.

scalpel: the omission wasn't deliberate. In fact, two of the high schoolers I observed were Hispanic; the one from Mexico got a scholarship to go to nursing school. Her presentation was one of the good ones.

Nor was my post just about illegal aliens. It's also about the trend, which seems to go hand in hand, toward fighting all kinds of immigration. My point is that children of immigrants seem to comprise a disproportionate percentage of successful students. It's an observation, not simply an opinion. What it all means, where it is going, is a matter of opinion, I'm sure. But at least in my part of the world, the trend is pretty clear.

I haven't read any political commentary calling for further restrictions on legal immigration. As you mentioned, legal immigrants tend to be among the higher achievers in our society.

Illegal immigration, however, is something altogether different. Amnesty (or whatever pseudonym is used to soften the concept) is an extremely polarizing topic and one that will be of huge importance in the upcoming election.

The distinctions between these two subsets of foreigners should not be blurred or confused, because the groups are not at all equivalent.

There's a bit of a sense of entitlement that (some) native-born people have, so when they see immigrants' children excelling, they become upset, as if scholarships, awards, jobs happen on some kind of seniority system.

Sid- What made this country great, and continues to do so, is that theoretically it never has mattered too much who your parents were, or what your ethnic background was. It was what you did every morning every day after getting out of bed, or in the case of surgeons such as us, what we did while saner folks were still in bed. Our actual record on this was far from perfect, and often shameful in the past, but always has been, and continues to be, far better than other countries’. Most people who criticize Rush have never listened to him at length. One of his major beefs is with people who demand equality of outcome, instead of equality of opportunity, or a certain benefit or protection because of membership in a group (race, sexual orientation, country of origin). Once we get beyond the rights enumerated in the Bill of Rights, one person’s “right” becomes another person’s obligation (e.g., the “right” to medical care, the “right” to education, the “right” to attend college free of exposure to “offensive” ideas- the very opposite of the open-minded education that you rightly champion. That’s why I think that this country is on the wrong track.

NCLB does not de-fund schools that are struggling. It de-funds schools that have proven themselves over several years to be incompetent at their basic task- providing basic literacy to their students. It provides a way for poor folks to get their kids out of failed (not “struggling”) schools. I did it with my money by sending my kids to private school when I was dissatisfied with the public schools. Poor folks should have some options too.

Bc cook- good riddance.Enrico- real cute that you know Spanish. I do too, I learned it in school. The USA has a “history of blood and shame” regarding its treatment of immigrants? Know of any country that doesn’t? Do you know of any country that has a better record of integrating and welcoming immigrants? Please enlighten us. In English, please.Xerxes- more important to keep Spanish out of Wal-mart? Wal-mart is a private company- they can speak all the Spanish they want. How about ensuring that people who want to be citizens of this country are conversant in basic English? That probably makes me a racist in your mind. You would no doubt think me homophobic, sexist, lookist, hegemonistic, and ageist.

jb: "equality of opportunity as opposed to equality of outcome." I think that's a very useful and thoughtful way to put it, and indeed seems to be the ideal. It's in the definition and execution, I suppose that the right and the left disagree. I happen to believe that the loudest on the right, Rush, Ann, etc, don't really believe the first part. I think they tend to look at the way it is and define it as the way it isn't. I do admit, though, that I find them impossiblel to listen to, so I may have missed something. But there's no question at all that they, and the loudest of their supporters, really believe that anyone who criticizes this country (and most especially this administration) is traitorous. Whereas I think criticism and skepticism is the only hope.

And, living as I do with a long-time school board member in a district that makes enormous effort, your vision of the NCLB is, prehaps, more theoretical than actual. It's not all bad, mind you. But it's not all good.

I offer no explanation, but it seems noteworthy that compared to medical schools, law schools (including mine, which is very diversity conscious) are relatively immigrant-free. Especially "top" law schools, where the bar to entrance is set rather high.

As I said, I do not know the explanation. It could be the aggregate result of many complex social forces and difficult if not impossible to understand. Or, the answer might simply be that immigrants are not interested in practicing law.

I do think that many Americans take something bordering on pride in anti-intellectual values. And that, to me, is extremely disturbing.

Irritatingly, for some reason the people who would like to see more God and less evolutionary biology in public schools are also the people who believe that science and technology will bail us out when our socially dangerous practices come to a head. (More in keeping with the themes of a medical blog, I suspect they are also the people who demand the fruits of science in the form of unnecessary testing and imaging like MRI and CT Scans when they get an owie.)

Anyway, most of the motivation for this comment was to share a Richard Dawkins speech I recently came across, which addresses this this very subject:

It would make a good breakfast listen some morning, like during pledge drive week, when NPR gets on your nerves.

Finally, regarding public schools: I went to a public high school, a rural public university, and now am a graduate student at another public university. For what it's worth, I think I turned out okay.

Actually, medical schools are also, as you put it, fairly immigrant free. Medical school is still pretty hard to get into (50% acceptance rate today as compared to 25% when I applied in the '70s). There is no shortage of American citizens who are academically qualified, and medical school is very expensive, even at state supported schools. Where the immigrants come in (the current PC term is IMG, for international medical graduate) is at the graduate medical education level, i.e., residency. Depending on the program and the specialty, a large percentage of the residents can be IMGs. The one I'm most familiar with is Surgery, where the most recent data show 18%. I believe but cannot confirm that is's a lot higher for other specialties.

It's a tough path for IMGs to come here. They have to pass a difficult test, and obtain a visa.

We could start a whole blog on the morality of the USA stripping India, the Philippines, and Mexico of its best medical talant.

About Me

I'm a mostly retired general surgeon. With my surgical blog, my intention is to inform, entertain, and possibly educate the reader about surgery, and about the life and loves of a surgeon: this one, anyway. Don't know what I'm thinking, doing a political blog, too.
In an amazing coincidence, I've also written a book, "Cutting Remarks; Insights and Recollections of a Surgeon." It's about my surgical training in San Francisco in the 1970s, aimed at the lay reader with the goal of entertaining with good stories, informing with understandable details of surgical anatomy, procedures, and diseases. Knowing you, I bet you'd enjoy it. In fact, if you like Surgeonsblog, you'll absolutely love the book!

Boring, Unoriginal, but Important Disclaimer:

What I say here is as true as I can make it, based on my experience as a surgeon. Still, in no way is it intended as specific medical advice for any condition. For that, you need to consult your own doctors, who actually know you. I hope you'll find things of interest and amusement here; maybe useful information. But please, please, PLEASE understand: this blog ought not be used in any way to provide the reader with ideas about diagnosis or treatment of any symptoms or disease. Also, as you'd expect, when I describe patients, I've changed many personal details: age, sex, occupation -- enough to make them into no one you might actually know. Thanks, and enjoy the blog.